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Long-term Survivors with Adult Acute Leukemia in Complete Remission: Complications and Return to Work

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For addressing, and eventually being able to predict and prevent, both disease-related complications and changes in social status in long-term acute leukemia survivors, the follow-up is the most important factor after treatment. To this end, we assessed the complications following the attainment of complete remission in adult acute leukemia patients and the changes in social status of patients surviving more than 5 years after disease onset. In our study population of 42 survivors, 24 (57.1%) suffered from various combinations of 18 types of identified complications including posttransfusion hepatitis, diabetes mellitus, and idiopathic osteonecrosis. Regarding fertility, 9 live births were recorded in this cohort, from 2 female patients and the partner of a male patient. Of these 42 long-term survivors, at the time of this report 48.5% were working full- or part-time, 9.0% were unemployed, 30.3% were homemakers, and 12.2% were retired.

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  1. 1.

    Kawamura S, Tamai Y, Konuma Y, et al. Favorable prognoses of 24 adult patients with acute leukemia surviving over five years, since 1985.Jpn J Clin Hematol. 1992;33:958–963.

  2. 2.

    Suzuki Y, Kawamura S, Nakui Y, et al. Postremission therapy without prednisolone produces better survival rate of adult acute leukemia.Hematol Oncol. 1996;33:508–514.

  3. 3.

    Kawamura S, Mikami T, Iwamura H, et al. Effect of the intermittent prophylactic treatment of the central nervous system in adults with acute leukemia.Biomed Pharmacother. 1987;41:462–467.

  4. 4.

    Ohno R. Current progress in the treatment of adult acute leukemia in Japan.Jpn J Clin Oncol. 1993;22:85–97.

  5. 5.

    Rowe JM, Tallman MS. Intensifying induction therapy in acute myeloid leukemia: has a new standard of care emerged?Blood. 1997;90:2121–2126.

  6. 6.

    Micallef IN, Rohatiner AZ, Carter M, et al. Long-term outcome of patients surviving for more than ten years following treatment for acute leukemia.Br J Haematol. 2001;113:443–445.

  7. 7.

    De Lima M, Strom SS, Keating.M, et al. Implications of potential cure in acute myelogenous leukemia: development of subsequent cancer and return to work.Blood. 1997;90:4719–4724.

  8. 8.

    Fujii Y, Kaku K, Tanaka M, et al. Hepatitis C virus infection in patients with leukemia.Am J Hematol. 1994;46:278–282.

  9. 9.

    Ribas A, Butturini A, Locasciulli A, et al. How important is hepatitis C virus (HCV)-infection in persons with acute leukemia?Leuk Res. 1997;21:785–788.

  10. 10.

    Paul IM, Sanders J, Ruggiero F, et al. Chronic hepatitis C virus infections in leukemia survivors: prevalence, viral load, and severity of liver disease.Blood. 1999;93:3672–3677.

  11. 11.

    Tamai Y, Takami H, Kariya K, et al. Hepatitis C virus infection in acute leukemia patents with long survival.Hematol Oncol. 1996;32: 276–280.

  12. 12.

    Chan-Lam D, Prentice AG, Copplestone JA, et al. Avascular necrosis of bone following intensified steroid therapy for acute lymphoblastic leukemia and high-grade malignant lymphoma.Brit J Haematol. 1994;86:227–230.

  13. 13.

    Thronton MJ, O’Sullivan G, Williams MP, et al. Avascular necrosis of bone following and intensified chemotherapy regimen including high dose steroids.Clin Radiol. 1997;52:607–612.

  14. 14.

    Greenberg DB, Kornblith AB, Herndon JE, et al. Quality of life for adult leukemia survivors treated on clinical trials of cancer and leukemia group B during the period 1971-1988.Cancer. 1997;80: 1936–1944.

  15. 15.

    Kornblith AB, Herndon JE II, Zuckerman E, et al. Comparison of psychosocial adaptation of advanced stage Hodgkin’s disease and acute leukemia survivors.Ann Oncol. 1998;9:297–306.

  16. 16.

    Estey E, Delima M, Strom S, et al. Long-term follow-up of patients with newly diagnosed acute myeloid leukemia treated at the University of Texas M.D. Anderson Cancer Center.Cancer. 1997;80: 2176–2180.

  17. 17.

    Kawamura S, Suzuki Y, Tamai Y, et al. Pregnancy outcome among long-term survivors with acute leukemia.Int J Hematol. 1995;62: 157–161.

  18. 18.

    Kawamura S, Ueda R, Ohno R, et al. Pregnancy among long-term survivors of acute leukemia. A second nationwide survey.Int J Hematol. 1998;67:37–43.

  19. 19.

    Takano S, Nakamura K, Kawai S, et al. Prospective assessment of donor blood screening for antibody to hepatitis C virus by firstand second-generation assays as a means of preventing post-transfusion hepatitis.Hepatology. 1996; 23:708–712.

  20. 20.

    Okuno M, Kojima S, Moriwaki H. Chemoprevention of hepatocellular carcinoma: concept, progress and perspectives.J Gastroenterol Hepatol. 2001;16:1329–1335.

  21. 21.

    Takano S, Omata M, Ohto M, Satomura Y. Prospective assessment of donor blood screening for antibody to hepatitis C virus and high!-titer antibody to HBcAg as a means of preventing posttransfusion hepatitis.Hepatology. 1993;18:235–239.

  22. 22.

    Ohnuma H, Tanaka T, Yoshikawa A, et al. The first large-scale nucleic acid amplification testing (NAT) of donated blood using multiplex reagent for simultaneous detection of HBV, HCV, and HIV-1 and significance of NAT for HBV.Microbiol Immunol. 2001; 45:667–672.

  23. 23.

    Health and Welfare Statistics Association. Statistics of main cause of death [in Japanese].J Health Welfare Stat. 1998;45:101–103.

  24. 24.

    Tanaka T, Hirota T. The etiology of ideopathic osteonecrosis [in Japanese].MB Orthop. 2001;14:1–5.

  25. 25.

    Pritchett JW. Statin therapy decreases the risk of osteonecrosis in patients receiving steroids.Clin Orthop. 2001;386:173–178.

  26. 26.

    Aisenberg J, Hsieh K, Kalaitzoglou G, et al. Bone mineral density in young adult survivors of childhood cancer.J Pediatr Hematol Oncol. 1998;20:241–245.

  27. 27.

    Hesseling PB, Hough SF, Nel ED, et al. Bone mineral density in long- term survivors of childhood cancer.Int J Cancer Suppl. 1998; 11:44–47.

  28. 28.

    Smith MA, Rubinstein L, Anderson JR, et al. Secondary leukemia of myelodysplastic syndrome after treatment with epipodophyllotoxins.J Clin Oncol. 1999;17:569–577.

  29. 29.

    Leone G, Mele L, Pulsoni A, et al. The incidence of secondary leukemias.Haematologica. 1999;84:937–945.

  30. 30.

    Cohen A, Roveilli A, van Lint MT, et al. Secondary thyroid carcinoma after allogenic bone marrow transplantation during childhood.Bone Marrow Transplant. 2001;28:1125–1128.

  31. 31.

    Travis LB, Gospodarowicz M, Curtis RE, et al. Lung cancer following chemotherapy and radiotherapy for Hodgkin’s disease.J Natl Cancer Inst. 2002;94:182–192.

  32. 32.

    Yamamoto M, Fukunaga Y, Tsukimoto I, et al. Late effect of childhood acute leukemia and its treatment.Acta Paediatr Jpn. 1991;33: 573–588.

  33. 33.

    Iarussi D, Indolfi P, Galderisi M, Bossone E. Cardiac toxicity after anthracycline chemotherapy in childhood.Herz. 2000;7:676–688.

  34. 34.

    Okumura H, Iuchi K, Yoshida T, et al. Brain natriuretic is a predictor of anthracycline-induced cardiotoxicity.Acta Haematologica. 2000;104:158–163.

  35. 35.

    Statistics Bureau, Ministry of Public Management, Home Affairs, Posts and Telecommunications. Unemployment rate [in Japanese].Int Stat. 1995;61.

  36. 36.

    Statistics Bureau, Ministry of Public Management, Home Affairs, Posts and Telecommunications. Unemployment rate [in Japanese].Int Stat. 2001;62.

  37. 37.

    Nash RA. Hematopoietic stem cell transplantation. In: Lee GR, Foerster J, Lukens J, et al, eds.Wintrobe’s Clinical Hematology. 10th ed. Baltimore, Md: Williams & Wilkins; 1999:875–893.

  38. 38.

    Strasser SI, Sullivan KM, Myerson D, et al. Cirrhosis of the liver in long-term marrow transplant survivors.Blood. 1999;93:3259–3266.

  39. 39.

    Cohen EP, Lawton CA, Moulder JE. Bone marrow transplant nephropathy: radiation nephritis revisited.Nephron. 1995;70: 217–222.

  40. 40.

    Schubert MA, Sullivan KM, Shuber MM, et al. Gynecological abnormalities following allogeneic bone marrow transplantation.Bone Marrow Transplant. 1990;5:425–430.

  41. 41.

    Watson M, Wheatley K, Harrison GA, et al. Severe adverse impact on sexual functioning and fertility of bone marrow transplantation, either allogeneic or autologous, compared with consolidation chemotherapy alone: analysis of the MRC AML 10 trial.Cancer. 1999;86:1231–1239.

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Author information

Correspondence to Yuhko Suzuki-Tsunoda or Setsuko Kawamura or Kenichi Tsushima or Yoshiko Tamai or Hideki Takami or Akihiro Munakata or Masashi Tsunoda.

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Suzuki-Tsunoda, Y., Kawamura, S., Tsushima, K. et al. Long-term Survivors with Adult Acute Leukemia in Complete Remission: Complications and Return to Work. Int J Hematol 76, 173–179 (2002).

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Key words

  • Acute leukemia
  • Long-term survivors
  • Complications
  • Return to work